As eating disorder professionals, ensuring our practice is neuroaffirming is crucial for effective, ethical care. This checklist, designed specifically with autistic and AuDHD clients in mind, can help you evaluate and improve your approach.
Language and Communication
Identity and Respect ✓
- Ask about and use preferred identity language (e.g., identity-first "autistic person" vs. person-first "person with autism")
- Respect and validate different communication styles
- Never describe behaviors as "rigid" or "picky" - use neutral terms like "consistent" or "selective"
- Acknowledge masking as exhausting and unnecessary in your space
- Use precise, literal language without idioms or abstract metaphors
Communication Adaptations ✓
- Offer multiple communication options (written, verbal, typed, AAC)
- Provide adequate processing time without pressure
- Give information in multiple formats (visual, written, verbal)
- Allow for non-traditional forms of engagement (walking meetings, fidgeting, looking away)
- Send session agendas and materials in advance
Environmental Considerations
Sensory Respect ✓
- Assess and accommodate lighting preferences
- Reduce background noise and echoes
- Maintain comfortable room temperature
- Offer seating options (firm/soft, with/without arms)
- Provide stim toys or fidget objects
- Create quiet spaces for breaks
Physical Setup ✓
- Clear signage and navigation
- Predictable office layout
- Minimal visual clutter
- Sensory break space available
- Consistent arrangement of furniture
- Option to adjust lighting or use sunglasses
Treatment Approach
Assessment Process ✓
- Recognise masking in traditional assessment tools
- Consider sensory experiences in food choices
- Acknowledge stimming as self-regulation
- Value different forms of emotional expression
- Look beyond traditional ED presentation models
Goal Setting ✓
- Focus on quality of life rather than "normalising" behaviours
- Include client's special interests when helpful
- Set goals that maintain rather than eliminate coping mechanisms
- Value client's own measures of progress
- Support autonomy in food choices
Food and Eating Considerations
Meal Support ✓
- Respect food temperature preferences
- Honour need for food separation
- Allow preferred utensils and dishes
- Maintain consistent meal environments
- Support specific preparation methods
- Recognise brand preferences as valid
Change Process ✓
- Value stability of safe foods
- Make changes gradually and predictably
- Maintain successful routines
- Support food exploration without pressure
- Allow for steps backward without judgment
Professional Development
Self-Reflection ✓
- Examine own biases about autism
- Challenge traditional ED treatment assumptions
- Question "compliance" narratives
- Recognise autistic expertise
- Stay updated on neurodiversity-affirming practices
Practice Enhancement ✓
- Seek supervision from autistic professionals
- Read autistic-authored resources
- Attend neurodiversity-affirming training
- Join neuroaffirming professional groups
- Advocate for systemic changes
Client Empowerment
Advocacy Support ✓
- Encourage self-advocacy
- Provide resources for peer support
- Support identity exploration
- Share autistic-created resources
- Connect with autistic community
Treatment Collaboration ✓
- Include client in all treatment decisions
- Validate lived experience
- Respect communication preferences
- Support autonomous choice
- Honour personal boundaries
Moving Forward
This checklist isn't about perfection—it's about progress. Regular reflection on these points can help create more inclusive, effective, and respectful eating disorder treatment spaces. Remember that each autistic person is unique, and while this checklist provides general guidance, individual preferences and needs should always guide your approach.
Consider reviewing this checklist quarterly to:
- Identify areas for improvement
- Celebrate progress made
- Set goals for continued growth
- Gather feedback from clients
- Update practices based on new learning
Your commitment to neuroaffirming practice makes a real difference in treatment outcomes and client wellbeing.
